Task Request for Volunteer/Volunteen Assistance



|[pic] |Volunteer Application |

| | |

| |Volunteers are vital to Worthington Libraries. We welcome community involvement in the Library |

| |and offer a variety of opportunities to match your interests, skills, and availability. |

| |In order to be considered for volunteer service, please fully complete this application. Thank|

| |you. |

| |

Name: ______________________________________________ Date: __________________

Address: ____________________________________________________________________

Home phone: _____________ Cell: _________________ Email: ______________________

I prefer to be contacted at: home ___ cell ___ email ___ no preference ___

Emergency contact: __________________________________________________________

(name/phone/relationship to you)

Employment history: please tell us about your most recent paid positions, if applicable:

|Employer |Dates of Employment |Description of your Duties |

| | | |

| | | |

Volunteer history: please tell us about your volunteer experiences, if applicable:

|Organization |Dates Volunteered |Description of your Duties |

| | | |

| | | |

Education (highest grade completed): ___________________________________________

School: _____________________________________________________________________

Gender: M___ Are you 18 years or older? Yes ___ No ___

Applicants under 18 years of age or not in their last quarter of high school should

F___ complete a Volunteen application, available at any customer service desk.

Are you applying for a specific volunteer position? If so, which one? _____________________

Do you need community service hours? Yes ___ No ___

If yes, for: college ___ workplace ___ court-ordered ___ other (explain) _________________

If yes, how many hours do you need? ________________ By what date? __________________

Are you applying for a short-term volunteer position? If so, what dates are you available?

____________________________________________________________________________________Why are you interested in volunteering with the Library?

____________________________________________________________________________________

____________________________________________________________________________________

I prefer to work: in public___ behind the scenes___ either___

I prefer to work: alone___ with a group___ either___

Areas of Interest (select all that apply). Please note: not all areas are available at all times or at all libraries:

| |Computers – data entry, spreadsheets, etc. | |Homebound program |

| |Decorating / displays / crafts | |Sorting and shelving library materials |

| |English Conversation Group | |Technical services / repairing materials* |

| |Gardening / landscaping | |Working with historic documents* |

| |Homework Help Center | | |

| |Library programs for children | |Other (please list): |

| |Library programs for teens | | |

| |Library programs for adults | | |

| |Preparing / organizing materials for programs | | |

| |Proficiency in a language other than English (please specify: | |* these areas available at Old Worthington Library only |

| |) | | |

Days and times available to work: _______________________________________________

Hours preferred per week: 1-2 ___ 3-4___ 4-6___ less frequent than weekly ___

Depending on assignment and workload, volunteers may work up to 6 hours/week.

I prefer to volunteer: on a regular schedule ___ as-needed / occasionally ___ both ___

Preferred location: Old Worthington ___ Northwest ___ Worthington Park___

Check all libraries where you are willing to volunteer.

I certify that all statements made in my volunteer application are true and correct to the best of my knowledge. I give Worthington Libraries the permission to verify all information contained in this application as may be necessary. I understand that I must submit to a background check before being assigned any volunteer responsibility at Worthington Libraries.

I understand that there is no salary or other compensation for my services as a volunteer. I understand that my assignment may be terminated by the Library or myself with or without prior notice at any time.

I agree to read, sign and adhere to the Volunteer Code of Conduct.

Signature:________________________________________________ Date: ______________

Please return your completed application by mail, email or fax to:

Outreach Services/Volunteer Coordinator

Worthington Libraries

820 High Street

Worthington, OH 43085

lsmith@

Fax: 614-807-2642

Or return it to any public service desk at Northwest, Old Worthington or Worthington Park Library

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